Implant systems, plates, bone fusion systems, and methods employing same

Abstract

Implant systems in some embodiments such as midline incision implant systems may generally include an insertion guide assembly and a plate, which define fixation trajectories. In other embodiments such as a percutaneous implant system may generally include a first a plate, an insertion guide, and a separate second insertion guide, which define fixation trajectories. Surgical methods include use of the implant systems with the plates, and use of plates alone, for installing bone fusion systems.

We claim: 
     
         1 . An implant system comprising:
 a plate comprising:
 a first surface opposite a second surface; 
 a first channel extending therethrough having a first axis defining a first trajectory, wherein the first channel includes a first opening at the first surface and a second opening at the second surface, and wherein the first opening is offset from the second opening; 
 a second channel extending therethrough having a second axis defining a second trajectory, wherein the second channel includes a first opening at the first surface and a second opening at the second surface, and wherein the first opening is offset from the second opening; 
 the first trajectory extending at an angle opposite a direction of the second trajectory, wherein the first trajectory overlaps with the second trajectory directly inferior to the second surface; 
   a first insertion guide comprising a first passageway therethrough, wherein the first insertion guide comprises a lower portion comprising a stop, an external threaded portion, and a lower cylindrical portion;   a second insertion guide comprising a second passageway therethrough, wherein the second insertion guide comprising a lower portion comprising a stop, an external threaded portion, and a lower cylindrical portion; and   wherein a lower end of the first insertion guide being releasably attachable to the plate so that the first passageway is alignable with the first trajectory, and a lower end of the second insertion guide being releasably attachable to the plate so that the second passageway is alignable with the second trajectory, and   wherein the lower cylindrical portion of the first channel receives the lower cylindrical portion of the first insertion guide and an internal threaded upper portion of the first channel receives the external threaded portion of the first insertion guide, and wherein the lower cylindrical portion of the second channel receives the lower cylindrical portion of the second insertion guide and the internal threaded upper portion of the second channel receives the external threaded portion of the second insertion guide.   
     
     
         2 . The implant system of  claim 1 , wherein the lower end of the first insertion guide is releasably receivable in the first channel of the plate, and the lower end of the second insertion guide is releasably receivable in the second channel of the plate. 
     
     
         3 . The implant system of  claim 1 , wherein the first channel of the plate comprises the internal threaded upper portion, a seat, and a lower cylindrical portion, wherein the seat is positioned between the internal threaded upper portion and the lower cylindrical portion, and the second channel of the plate comprises a threaded upper portion, a seat, and a lower cylindrical portion, wherein the seat is positioned between the internal threaded upper portion and the lower cylindrical portion. 
     
     
         4 . The implant system of  claim 1 , wherein the plate comprises a means for connecting to a handle. 
     
     
         5 . The implant system of  claim 1 , wherein the plate comprises a threaded opening disposed between the first channel and the second channel. 
     
     
         6 . The implant system of  claim 1 , wherein the first trajectory is disposed at a first end of the plate, and the second trajectory is disposed at a second end of the plate. 
     
     
         7 . A method for using the implant system of  claim 1 . 
     
     
         8 . An implant system comprising:
 a plate comprising:
 a first surface opposite a second surface; 
 a first channel extending therethrough having a first axis defining a first trajectory, wherein the first channel includes a first opening at the first surface and a second opening at the second surface, and wherein the first opening is offset from the second opening; 
 a second channel extending therethrough having a second axis defining a second trajectory, wherein the second channel includes a first opening at the first surface and a second opening at the second surface, and wherein the first opening is offset from the second opening; 
 the first trajectory extending at an angle opposite a direction of the second trajectory, wherein the first trajectory overlaps with the second trajectory directly inferior to the second surface; 
   a first insertion guide comprising a first passageway therethrough;   a second insertion guide comprising a second passageway therethrough; and   wherein a lower end of the first insertion guide being releasably attachable to the plate so that the first passageway is alignable with the first trajectory, and a lower end of the second insertion guide being releasably attachable to the plate so that the second passageway is alignable with the second trajectory, and   wherein the plate has a polygonal shape.   
     
     
         9 . A surgical method comprising:
 providing a plate the plate comprising:
 a body comprising:
 a first surface and a second surface, wherein the second surface is a bone contacting surface; 
 a first opening at a first end of the body extending from the first surface to the second surface; 
 a second opening at a second end of the body extending from the first surface to the second surface; 
 a third opening positioned between the first opening and the second opening and extending from the first surface to the second surface; 
 the first surface defining a first boss extending around at least a portion of the first opening and wherein the first boss extends away from at least a portion of the first surface; and 
 the first surface defining a second boss extending around at least a portion of the second opening and wherein the second boss extends away from at least a portion of the first surface; 
 
   positioning the plate adjacent to an anatomical structure of a spine;   inserting a first elongated member through the first opening of the plate and into a first pedicle of the spine, wherein the first elongated member comprises a first cannula;   inserting a second elongated member through the second opening of the plate and into at least one of a facet or a second pedicle of the spine, wherein the second elongated member comprises a second cannula;   verifying the placement of the plate, the first elongated member, and the second elongated member relative to the anatomical structure;   inserting a first fixation element through the plate and into first pedicle;   inserting a second fixation element through the plate and into the at least one facet or second pedicle; and   removing the first elongated member and the second elongated member from the first pedicle and the at least one facet or second pedicle so that the plate and the first fixation element and the second fixation element form a bone fusion system in the spine.   
     
     
         10 . The surgical method of  claim 9 , further comprising inserting a first cannula through the first opening in the plate and into the first pedicle, and wherein the inserting the first elongated member comprises inserting the first elongated member through the first cannula, and further comprising inserting a second cannula through the second opening in the plate and into the at least one facet or second pedicle, and wherein the inserting the second elongated member comprise inserting the second elongated member through the second cannula. 
     
     
         11 . The surgical method of  claim 10 , wherein the inserting the first fixation element comprises inserting the first fixation element over the first elongated member, and the inserting the second fixation element comprises inserting the second fixation element over the second elongated member. 
     
     
         12 . The surgical method of  claim 9 , wherein the fixation elements form a V-shape configuration in the bone fusion system. 
     
     
         13 . A surgical method comprising:
 providing a plate, the plate comprising:
 a body comprising:
 a first surface and a second surface, wherein the second surface is a bone contacting surface; 
 a first opening at a first end of the body extending from the first surface to the second surface; 
 a second opening at a second end of the body extending from the first surface to the second surface; 
 a third opening positioned between the first opening and the second opening and extending from the first surface to the second surface; 
 the first surface defining a first boss extending around at least a portion of the first opening and wherein the first boss extends away from at least a portion of the first surface; and 
 the first surface defining a second boss extending around at least a portion of the second opening and wherein the second boss extends away from at least a portion of the first surface; 
 
   positioning the plate adjacent to an anatomical structure of a spine;   inserting a first elongated member through the first opening of the plate and into a first pedicle of the spine, wherein the first elongated member comprises a first guide wire;   inserting a second elongated member through the second opening of the plate and into at least one of a facet or a second pedicle of the spine, wherein the second elongated member comprises a second guide wire;   verifying the placement of the plate, the first elongated member, and the second elongated member relative to the anatomical structure;   inserting a first fixation element through the plate and into the first pedicle;   inserting a second fixation element through the plate and into the at least one facet or second pedicle; and   removing the first elongated member and the second elongated member from the first pedicle and the at least one facet or second pedicle so that the plate and the first fixation element and the second fixation element form a bone fusion system in the spine.